Are patient-reported outcomes improved by implant-assisted maxillary prostheses compared to conventional maxillary dentures? A systematic review

Objectives: Edentulism can be treated with conventional complete dentures or implant-assisted prostheses. While two-implant assisted overdentures are superior to conventional mandibular dentures, the effectiveness of maxillary options remains unclear. This systematic review aims to assess whether conventional or implantassisted maxillary prostheses provide better satisfaction and quality of life for patients with edentulous maxilla. Data and sources: An electronic search was conducted across Medline (PubMed), Scopus, Embase, and the Cochrane Library up to May 23, 2024, to find studies comparing satisfaction and oral health-related quality of life in patients using conventional maxillary dentures versus implant-assisted maxillary prostheses. Study selection: Out of 1119 retrieved articles, 1085 were deemed irrelevant after screening, and 34 studies were evaluated for inclusion. Only six studies met the criteria, with the main reason for exclusion being the lack of comparison between new implant prostheses and new conventional dentures, as opposed to old unsatisfactory conventional maxillary dentures. Due to limited sample sizes and high heterogeneity, a meta-analysis was not feasible. The literature did not show significant differences in quality of life or satisfaction between conventional and implant-assisted complete maxillary prostheses, except for patients with pre-treatment preference toward implants. Conclusions: There is no evidence supporting the superiority of either conventional or implant-assisted prosthetic options for restoring the edentulous maxilla. Further well-designed clinical studies are needed to compare new conventional and new implant-assisted complete maxillary prostheses with different designs. Clinical significance: Conventional and implant-assisted complete maxillary prostheses appear equally successful in restoring the quality of life and satisfaction of patients with an edentulous maxilla. The cost and morbidity associated with implant-assisted prostheses may be greater. A properly made conventional denture can serve as a diagnostic tool to assist treatment planning.